Provider Demographics
NPI:1447622279
Name:DIVER, JAMEE (IBCLC)
Entity type:Individual
Prefix:
First Name:JAMEE
Middle Name:
Last Name:DIVER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 W ARIELLE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1465
Mailing Address - Country:US
Mailing Address - Phone:937-657-8101
Mailing Address - Fax:
Practice Address - Street 1:668 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1575
Practice Address - Country:US
Practice Address - Phone:937-657-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN